- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,044.99 / $4,113.09 / $10,517.90
| Facility | | $2,044.99 | $4,113.09 | $10,517.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,283.00 / $4,975.00 / $11,448.00
| Facility | | $3,283.00 | $4,975.00 | $11,448.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,288.60 / $3,288.60 / $37,499.62
| Facility | | $3,288.60 | $3,288.60 | $37,499.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,765.00 / $2,654.64 / $7,227.90
| Facility | | $1,765.00 | $2,654.64 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,628.99 / $1,628.99 / $1,628.99
| Facility | 62 | $1,628.99 | $1,628.99 | $1,628.99 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $260.64 / $260.64 / $260.64
| Facility | AS | $260.64 | $260.64 | $260.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.00 / $1,440.00 / $6,241.86
| Facility | | $332.00 | $1,440.00 | $6,241.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,152.23 / $2,152.23 / $2,152.23
| Facility | | $2,152.23 | $2,152.23 | $2,152.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.00 / $2,654.64 / $7,227.90
| Facility | | $597.00 | $2,654.64 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,628.99 / $1,628.99 / $1,628.99
| Facility | 62 | $1,628.99 | $1,628.99 | $1,628.99 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $260.64 / $260.64 / $260.64
| Facility | AS | $260.64 | $260.64 | $260.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $996.00 / $4,194.00 / $9,020.04
| Facility | | $996.00 | $4,194.00 | $9,020.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,756.03 / $2,756.03 / $8,573.15
| Facility | | $2,756.03 | $2,756.03 | $8,573.15 |